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moviedoc September 30th, 2009 01:13 PM

AMA/APA ethics code: support of universal care
Section 9 of the AMA ethics code, which seems to be adopted automatically by APA states: "A physician shall support access to medical care for all people."

I question the relevance of this to the physician patient relationship, but more importantly it would seem that it could be applied, for example, to a physician who voted for a candidate for public office who opposed universal access to health care or to a physician who publicly opposed such access on his or her own.

This seems to be a political rather than ethical matter or a matter of conscience that a professional organization should leave to the individual.

Will these organizations now tell us the "ethical" position on gun control, abortion? Even where "torture" is involved we are not told it is unethical to support torture, only to pariticipate.

William Reid October 7th, 2009 09:43 AM

Re: AMA/APA ethics code: support of universal care
The American Psychiatric Association (not the other, larger "APA" which is the American Psychological Association) does indeed automatically adopt the American Medical Association's "Principles of Medical Ethics" as its own ethical foundation. APA long ago decided that, being an organization of physicians, all members should first meet the ethical principles of medical doctors, then also meet those specific to the practice of psychiatry (known in the APA version as "Annotations Especially Applicable to Psychiatry").

One may note that these principles and annotations are specific and limited -- as to any "official" standing -- to the organizations which promulgate them. While they may be a great set of guidelines, they are enforceable only by the organizations themselves, and only against members of those organizations. Professional ethics are not matters of law unless the particular ethics matter has been separately adopted by some governmental body as law or rule (cf., clinician-patient sexual behavior in most states). That's one reason I sometimes suggest that patients and their families choose therapists who belong to a major professional organization that has written ethics canons. In such cases, the clinician's personal ethical standards (the most important thing) are backed up, to some extent at least, by the organization's expectations.

Someone else will have to comment on the "political" issues.

Da Friendly Puter Tech October 7th, 2009 04:54 PM

Re: AMA/APA ethics code: support of universal care
A doctor does not deserve that titel if he or she does not support access to medical care for all human beings.

Da Friendly Puter Tech

William Reid October 10th, 2009 09:03 AM

Re: AMA/APA ethics code: support of universal care
Hard to disagree. Fortunately, we already have that in the U.S. (think carefully before you say it's not so). I wonder, though, if you mean equal access for all persons to all services, regardless of who pays for it? I really worry about the consequences -- intended and unintended -- of the plans currently being considered by Congress and the Administration.

Da Friendly Puter Tech October 10th, 2009 03:58 PM

Re: AMA/APA ethics code: support of universal care
Huh? That is not the way it looks from my point of view.

However, this isnt a political board, so I guess its not worth continuing the argument.

I do wonder though, what on earth consequences is it that are so scary with strong universal health care for all? Is it better all around health care for all that is scary? I mean, sure, thats gotta be frightening. We cant have something so terrible - good health care for all. Terrible. The working poor might get more healthy. Thats a terrible option.

I truly do not understand the terror displayed by republicans of this option.

It works quite well in a number of western countries. All we have to do is learn from them. Then again, that would mean admitting that we are not God-like in the US. Terrifying.

Da Friendly Puter Tech.

William Reid November 23rd, 2009 10:27 AM

Re: AMA/APA ethics code: support of universal care
Many of us in the APA are very upset that the organization takes social and political positions -- regardless of what the position may be -- that have very little directly to do with patients or psychiatrists. We consider it divisive and a poor use of resources which should focus on patients & psychiatrists. The ethical position of supporting access to care would not be one of those, though, since it speaks directly to patient care. However, I'd be surprized if the APA officially said something like "it's unethical to vote against nationalized health care" (though the leadership of APA is very liberal right now, and has been for years). Many of us (including I) would quit APA over such a position.

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